Endocrine Pharmacology USMLE Step 1 Practice Question
A 19-year-old man with type 1 diabetes mellitus presents with abdominal pain, vomiting, and altered mental status after missing two days of insulin doses. Vital signs show BP 98/62 mmHg, HR 118 bpm, RR 28 (Kussmaul respirations), temp 37.2°C. Examination reveals dry mucous membranes and decreased skin turgor. Labs reveal glucose 620 mg/dL, pH 7.22 with anion gap 16 mEq/L, potassium 5.9 mEq/L, bicarbonate 10 mEq/L, and negative serum ketones initially. He denies recent cocaine use. Which insulin preparation is most appropriate to initiate intravenously?
Answer choices
- ARegular insulinCorrect answer
- BInsulin lispro
- CInsulin degludec
- DInsulin glargine
- ENPH insulin
- FInsulin detemir
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